Have No Doubts
I am often asked questions about the diagnosis of a blighted ovum because of my own misdiagnosed blighted ovum story.
Six years ago, when facing my own diagnosis, there was virtually no information on misdiagnosed miscarriages online. In fact, women on miscarriage sites told me, kindly, to just have the D&C and move on.
Thankfully, I did not listen, and my daughter is here today.
You may or may not have that happy ending. Unfortunately, time is the only true test of a blighted ovum. I'd like to share some of what I've learned so far so that you can make an informed decision on how and when to end your pregnancy or whether it needs to be ended at all.
I believe every woman deserves not to have any doubts before ending her pregnancy.
I am not a medical professional. The information I share here is not meant to replace the information given to you by your doctor. If you feel your doctor is not doing enough for you or is not willing to listen to your concerns, I strongly encourage you to get a second opinion.
What Is a Blighted Ovum?
Let's start with the basics. A blighted ovum is an egg that is fertilized but does not develop after implantation. Your doctor may also refer to this as an anembryonic or empty sac pregnancy.
Let's move on to how a blighted ovum is diagnosed.
If you are able to see a yolk sac during the ultrasound, you do not have a blighted ovum. A baby is needed for the yolk sac to appear. That does not mean the pregnancy will not end in miscarriage, it just means you do not have a blighted ovum.
How a Blighted Ovum Is Diagnosed
Note: Please read through this entire section because the criteria given to doctors for diagnosing a blighted ovum are not always correct, and mistakes are frequently made.
Unfortunately, many doctors make the diagnosis too early. In a nutshell, a physician will often diagnose a blighted ovum when the gestational sac is empty. Some women have said they were diagnosed as early as five weeks.
According to the Encyclopedia of Medical Imaging, the criteria for a diagnosis of a blighted ovum are:
- Failure to identify an embryo in a gestational sac measuring at least 20 mm via transabdominal ultrasound.
- Failure to identify an embryo in a gestational sac measuring approximately 18 mm or more via transvaginal ultrasound.
- Failure to identify a yolk sac in a gestational sac measuring 13 mm or more.
This is the criteria many doctors use when making the diagnosis of a blighted ovum. Fortunately, there is still hope even when these "benchmarks" are not met.
How Do You Know If This Is Truly a Blighted Ovum?
Unfortunately, the only true way to test for a blighted ovum is time. If you've been told a baby is always seen by seven or eight weeks, you've been misinformed. Many women with gestational sacs measuring bigger than 20 mm find their babies after eight weeks.
Read More From Patientslounge
The UK is the first to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynecologists have revised its guidelines. If your gestational sac is more than 25 mm and/or the CRL is 7 mm or more, you should wait a week to verify, if there are no complications. If the measurements are less, you are too early to diagnose.
The vast majority of women who find their babies after eight weeks have a tilted uterus. Although some women who have an anteverted uterus (normal position) have found their babies later as well.
Does a Tilted Uterus Matter?
First things first, if you are being diagnosed with a blighted ovum before nine weeks, it is too early to know with certainty that it is indeed a blighted ovum. If you do not know if you have a tilted uterus, you need to ask your doctor because that should be verified before making a diagnosis.
After nine weeks, some women have reported finding their babies. Although most women see their babies by nine weeks, some women have been further along. We don't know the explanation as to why it takes so long to view some babies, but it does happen.
Also, do not be worried if you are told you look one to two weeks behind. Many women with a tilted uterus look one to two weeks behind even if they are certain of their conception date. In fact, many women are misdiagnosed after IVF for this very reason. Once these women hit the second trimester and their uterus is no longer retroverted, their dates line up.
How Do You Know When to End the Pregnancy?
If you would rather have a medical miscarriage, called a dilation and curettage (D&C), than a natural miscarriage, that is your right. Many doctors still encourage a natural miscarriage up to ten weeks. After ten weeks, even if you decide to have a natural miscarriage, you are more likely to need a D&C due to complications.
Low hCG Levels
Keep in mind that hCG levels start to slow down and plateau or even decline after seven or eight weeks of pregnancy. So hCG monitoring is not an accurate way to determine if this is a blighted ovum. However, if you are monitoring your hCG levels and they are significantly dropping, then you know your body is probably preparing for miscarriage.
Spotting or Bleeding
Bleeding is also not a very reliable sign of a blighted ovum. As many as one in three women will spot or bleed during their pregnancies.
Over Ten Weeks
If you get to ten weeks and are certain of your conception date, and there is still no baby found on the ultrasound (performed by a trained technician), you can be reasonably certain that you have a blighted ovum. Some women have found their babies later, and while they are the exception to the rule, this may be something you want to consider.
What it boils down to is that you shouldn't be pressured into a D&C too early. You can wait out a diagnosis. If you discuss the signs of infection with your physician and stay monitored, you can choose to wait. Some women only wait a week or so, and others end up waiting four weeks or more. The waiting is miserable, but it is the only way to know for sure what is happening.
Many women find their babies after eight or nine weeks. If you are being diagnosed before nine weeks, you have a greater risk of being misdiagnosed.
What Are Your Options After Being Diagnosed?
If you still have hope that this might be a viable pregnancy, there are a few things you can do.
- Ask to have your hCG levels monitored. As stated before, hCG levels are not reliable after about seven weeks because they slow down and begin to plateau. However, if your levels are really low, or if you see that your numbers are dropping significantly, then it may end in miscarriage. I've talked to women whose numbers began plateauing at around 30,000 with no baby seen. They turned down their D&C and continued on with a viable pregnancy. That does happen.
- Make certain your ultrasounds are done by fully-trained ultrasound technicians. Recent studies have shown that physicians tend to make mistakes when it comes to ultrasounds because they only have cursory training with the equipment and may not use it properly. If you are pregnant, your baby may be at risk from improper use. Don't be afraid to ask to have your ultrasounds done by a fully-trained technician.
- You can decline to have the D&C. According to the Journal of Family Practice and other medical organizations, a woman can safely wait to miscarry naturally if she:
- does not have a fever,
- has stable vital signs,
- has no excessive pain, and
- has no excessive bleeding.
Also, if you are ten weeks or less, many doctors encourage waiting for a natural miscarriage.
When Should I Get a Second Opinion?
If you feel pressured to end your pregnancy before you are certain it is going to end in miscarriage, and there are no complications, get a second opinion. Some women have told me they've even gotten third or fourth opinions before finding their babies!
I think a second opinion is only necessary if your doctor does not want you to wait and there are no complications. As I stated before, time is the only true test for a blighted ovum. If a trained technician in the first office does not see your baby, chances are a trained technician in the second office will not see your baby either. They'll have to wait until you are far enough along.
It is crucial to have a physician who will listen to your concerns and not rush a D&C. Having a doctor who is compassionate and understanding is incredibly helpful when going through this stressful and uncertain time.
Find the Support You Need
This may be one of the loneliest and most miserable times you will go through. Honestly, the waiting is awful, and the only thing that helps is knowing you are not alone and that you have support.
Open up to close family and friends to help you through this time. There are also support groups and online forums that can be helpful. Many women join an online support group, like the Misdiagnosed Miscarriage forum, because finding a community of other women experiencing this or who have experienced it in the past is priceless and helps you feel less alone.
Have I left anything out? Can you think of anything I can add to make this article more useful? Do you just need somebody to listen? Please, leave a comment below. If you are someone who isn't comfortable posting in public forums, please feel free to reach out to me personally through my profile. I would be honored to help you. Really though, just having somebody who will listen and be supportive is the best way to get through this.
Chaudhry K, Siccardi Ma. Blighted Ovum (Anembryonic Pregnancy) [Updated 2018 May 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK499938/
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Beatrice on October 26, 2019:
I took my first scan and it showed I was eight weeks with no embryo no yolk sac no collection of fluid noted but I was giving my due date and I was told I had blighted ovum but I went to take another scan the following day at a different hospital and I was told I was seven weeks and some days gone but liquor volume is adequate with regular thick walled intrauterine gestational sad with yolk sac. But no embryonic activity seen so I should repeat scan in one week. Am really worried.
Kay (author) on November 08, 2015:
Having that next ultrasound is your best bet. That way you can see if the sac is growing. If it is more than 25mm and empty, then you likely have your answer. But, based on your last measurement, you should be just about 25mm and, if so, you'll need to decide what to do. (((hugs)))
Gastemia on November 04, 2015:
Hi, I am sharing my current story in hopes of some kind of reassurance.
I went to my first transvaginal scan at 8 weeks. It took the doctor 10 secs to tell me I had a blighted ovum. No blood taken, no questions asked, nothing. She immediately prescribed me some pills to take and have an abortion. After that, she took a blood sample. The next day I called to get my blood results, in which the first thing she asked when I called was if I had taken the pills she prescribed. I told her NO. And I'm calling to get my blood results as I want a second opinion. She gave me my results.. my hcg levels were 73,000, that's it. No other results. I called a different doctor, and scheduled an appointment 4 days later. This new doctor is the sweetest doctor! She performed another transvaginal scan which showed my gestational sac of 6 weeks, but empty. No fetal pole.. My hcg levels are 62,000 with a 13.1 progesterone and Gestational sac of 17.5 mm. According to my LDP I should be 9 weeks. She recomended another scan in a week. I have NOT bled or are cramping at all. But my pregnancy signs have been diminishing. My boobs don't hurt anymore and I haven't been that hungry. I blame it on the depression and stress I'm going through. I want to keep my hopes up, since I'm not bleeding...yet... any hope??
Erica Rollins on August 07, 2015:
I am 7 weeks pregnant and have had some spotting here and there with this pregnancy. I went to the hospital yesterday and they did a transvaginal ultrasound that placed me at 7wks 2days. We saw a gestational sac, a yolk sac measuring 1.7cm but no fetal pole... my HCG levels are still rising as normal, but the doc is saying if my yolk sac reaches 1.8cm with no fetal pole in sight, that I will be diagnosed with blighted ovum. I've read any and every site online about blighted ovums and I truly appreciate all of you women who took the time to share your stories with me! I desperately want my baby, and this news has shattered my world, but reading your stories give me hope. Any advice would be much appreciated being that no one around me knows anything about a blighted ovum. I just continue to pray and ask God to give me a heart that praises him no matter what. I have a doctor appointment today just so my doc can tell me the same thing the hospital doc told me about the blighted ovum I assume. Hes going to schedule one more follow up ultrasound to see if we can see a fetal pole and hear hb... please pray for me ladies as I am praying for all of you. God bless
Kay (author) on June 27, 2015:
I am sorry you are going through this scare. The good news is that generally one week after the yolk sac is seen, the baby will be seen if the pregnancy is viable. Make sure you have an ultrasound tech do your ultrasound and not the doctor. (((hugs))) and keep us updated.
Amanda on June 25, 2015:
I am going through a lot of the same simi pregnancy issues. I went to my doctors 2 weeks ago my ultrasound said that I was 5 weeks and 4 days along. I went to my appointment yesterday and my ultrasound measured 5 weeks and 5 days. She has me come back today my shaft measures 6 weeks 2 days with a yolk sac. But there's no baby and there's no heartbeat. I'm really worried I just had a miscarriage at the end of last year but it was nothing like this pregnancy. I have a5 year old son and the pregnancy with him was nothing like this one. I am lost for words and don't know what to think right now :-(
Kay (author) on February 13, 2015:
If there are no complications, you might want to schedule an ultrasound a week out to make sure there is no growth and no baby. (((hugs)))
Robin marr on February 11, 2015:
I went for my 9 week prenatal appointment and ultrasound and was told I had a blighted ovum. I have had no miscarriage symptoms and still feel pregnant. I'm not sure what to think of this diagnosis.
anonymous on June 05, 2013:
Hello I just went today to have my first ultrasound they said I'm less then 6 weeks pregnant. When the did the vaginal ultrasound procedure the seen a sac with no baby me having 2 kids I was crushed when they told me that and all my hope and excitement was lost they had me give blood to check my hormone level and I have to go back for 2 more days to keep checking just a little nervous but after reading this I have a little hope.
anonymous on November 06, 2012:
Hi I should be about 8weeks went last month to the doctors baby was visible with yolk sack. Yesterday i was told the yolk sack grew but not the baby its measuring very small. I have a DC scheduled Monday Nov. 12 not sure what to do.
anonymous on November 05, 2012:
hi kay,i went for my first u/s last week when i was 8.1 weeks. i was very sad to hear that i had an empty sac with no embryo that could be spotted. i have had no signs of bleeding or miscarriage, the doctor told me that it would proberly happen naturally. i have booked another u/s for two weeks from now, and after reading the stories on your page i am trying to be really positive about it but it is really hard. just wondering how long you think to wait is too long, if i am going to miscarry is it likely to happen soon or could it take months. thanks niki
anonymous on September 30, 2012:
Hi Kay,I just wanted to say thanks so much for this post - it has all the information I was looking for in one place! I went for an early US a couple days ago after having spotting for a few days. I have a tilted uterus and was told I look more like 5/6 weeks when I thought I was closer to 7 and a half. I have a gestational sac and a yolk sac and the doc saw a dot which she said could be the baby but have to go back in a week. I think doctors are too scared to interpret anything they see for fear of a comeback if they're wrong. While I understand this, it makes it really difficult for women going through early pregnancy as they're often not given enough information or given a very negative view of what might happen so the doctor feels "covered".It's going to be a torturous week wait but your page has really helped - thank you!!
anonymous on July 04, 2012:
@anonymous: I am very sorry, I am going to the same problem with you, I think you should change your doctor and have a new one for your own good.
anonymous on July 04, 2012:
@anonymous: I am very sorry, I am going to the same problem with you, I think you should change your doctor and have a new one for your own good.
anonymous on April 28, 2012:
hi i have had a blighted ovum miscarrige 3 yrs after my first child. then i had a healthy baby girl in may 2011 but now i am pregnant. my husband an i were not trying for this pregnancy so i had no i idea i was prego. i paid much attention to my perido date cuz they are mostly on time, so when my doc tor tells me i am about 8wks i have my doubts. today when i visted my doctor she says there is no baby. i am not sure if i would believe i have a blighted ovum or not, cuz i feel very slight sickness and brest tenderness where as with the first B/O i felt the same way. my pregnancys are very hard when it come to the sickness..(been to er for dehyradtion because of throwing up so much) so what do u think is there chance of blighted ovum even after a healty pregnancy?
anonymous on March 30, 2012:
im 6week 6days pregnent with my 2nd baby, i was told after 2 us tht m hvng blighted ovum, so my dr planned out d&c today at 7w2d. Bt now after reading u , i dnt want to go hosp. Will wait till 10weeks or for natural miscarrige
anonymous on December 20, 2011:
I am very unsure of my conception date although my doctor was very rude and yelled at me for the last day of my last period and I estimated a date that could be completely wrong. So I am 12 weeks (so we think due to my awful estimating) my gestanional sac is 23 mm and a yolk sac is visible. Although there is no fetal pole visible.. Please help my doctor is extrememly unhelpful she has been from the begginging and I am going to get a second opinion. If my gestantional sac is 23mm is it okay for a fetal pole not to be visible yet? I have had no bleeding or pain although my breasts are no longer tender and sore. Some advice would be great because I would hate to get a d & c if I could possibly have a baby appear in a matter of weeks. I am concerned about the size of the gestantional sac. I dont know anything about this i am researching as much as I can. Please help.
anonymous on October 18, 2011:
@MommyMvdM: Hello need to tell me what ate ur hcg levels I waited it out because I though if my hcg levels were raising then they had to be wrong I had to have a baby in there if ur levels of hcg are over 16000 with no fetus jut a sac then there never will be one as hard as thy is to hear trust me I know on Thursday the 13 of October 2011 I just had to have a d&c it is so hard to say yes to have them take out ur sac because u want to have a baby trust me I know but I waited till I was 10 weeks and 2 days before I went infor my D&C I let my hcg levels raise to 75000 which was why I had to have a d&c because my placenta got to big for them to let me miscarry so I had no choice so if u levels r above why u said and still no baby let them help u get rid of the sac sooner u let them do it the fast u get to recover and sooner u get to try again
MommyMvdM on October 18, 2011:
@anonymous: I already have a beautiful daughter whose heartbeat we saw at 7 weeks and 3 days. I went for an ultrasound with this pregnancy at 7 weeks 4 days and the dr told me that she doesn't have good news as she can't find a fetus or a heartbeat but there's a yolk sac and the gestational sac measures at 7 weeks as well? Should I wait it out? I'm really worried as we saw my daughter and her heartbeat at 7 weeks and 3 days?
anonymous on October 04, 2011:
i am 8 weeks pregnant today and have been told all i have is an empty sac they want me to have a d&c on monday but i really want to wait my hcg is rising normaly they r now at 32000 but still no baby or yock sac should i still wait
anonymous on June 03, 2011:
Hi, I'm Amber and a few weeks ago I found out I was pregnant. I ended up going to the ER cause of cramping and they told me I could be having an ectopic pregnancy or it was just to early to tell. My hcg levels were around 2300 and only went to 2700 a couple days later when i went to my obgyn for a follow up.. She had an u/s done and there was still nothing to be seen. She told me I could be having a blighted ovum. When I got more blood work done they went to 4100 and my sac got larger but still nothing in the sac. I'm supposed to be 8 weeks 4 days from my last period and shes gonna give me one more week to get blood work done and another u/s, but said I'll prolly have to have a d&c the next day after my appt. I've read how peoples hcg levels slowly rise and they have a healthy baby. This is my first pregnancy and I'm getting myself prepared for the d&c but reading about everyone else makes me want to wait. What do you think I should do?
anonymous on April 30, 2011:
Your information is wonderful and w/out bias which I appreciate. The run around is getting old, I just needed the facts. I would love to be able to chat w/ you. My hormones are going up but each u/s has been more devastating than the last. I can't get that image out of my head. I almost gave up b/c this is so difficult. I'm glad I didn't. Last time they gave my options. My hcg was 8800.. they told me to go in and get another test. I waited and finally did b/c they told me to expect the results to have dropped. When I heard the number 17,000.. all I could think is what is going on here? Altho I'm not far along, I have had weekly u/s and hcg taken every other day. So this has been going on awhile. I was supposed to be about 6 or so weeks. My uterus is tilted to the back. No pain, no bleeding, no spotting... So by nine weeks I should be able to see something? Thanks again for the info. It is desperately needed as you mentioned.
anonymous on January 19, 2011:
@anonymous: Ashley,Please feel free to email me directly. I can answer anything you may want to ask. I was only 28, when they diagnosed me. It is a horrific thing to have to go through. I am here for you, I wish I had someone there for me when I went through it. That is one main reason I am still active in this thread. Cause it is an awful thing to have to go through. I will keep you in my prayers.
anonymous on January 19, 2011:
Thank you Mary,I have talked to my fiance about what I have read here and we plan on reading more when he gets off work today, but I think we will wait for a D&C I am just having a hard time it being my third pregnancy and still no baby I just feel like giving up! I am only 24yrs old and afraid we will never have a family like we've wanted! The hardest part is going through all the pregnancy symptoms, but be told a baby will not be there in the end...But thank you for the support!
anonymous on January 19, 2011:
Ashley,I am the one who started this thread. Please Please wait. If you still feel pregnant than wait. I am living proof that modern medicine has its faults, and people can be careless. I have a happy healthy 10 month little boy because I trusted my instincts. Wait a few weeks, and have another ultrasound. Also have them test your hormone levels once a week. I am so sorry you are going through this. I know how it feels, helpless. Please email me if you have anymore questions. MaryMorse951@gmail.com
anonymous on January 19, 2011:
Hi I have been diagnosed with a blighted ovum at 6.6 my doc wants to do another u/s at 7.6 and then schedule a d/c, but I'm afraid to. I am still having am sickness, tender breasts, and I am always tired and urinating! How long should I wait?? This is my 3rd preg my 1st I got a d/c b/c misscarrige at 8.5 the 2nd a fallopian tube hade to be removed due to tubal pregafter reading I have a little hope and afraid to rush but I am ready to deal with my3rd loss
dermatologist on November 22, 2010:
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anonymous on April 21, 2010:
This is great that you are doing this, but I feel horrible. 14 almost 15 years ago I was told I had a blighted ovum. I had a D&C, now this makes me wonder if maybe I didn't have a blighted ovum! I am very pro-life, so this makes me very sad. I grieved so much for that lost child.
anonymous on January 28, 2010:
I was diagnosed with a blighted ovum in July of 2009. I am here to tell you, if your doctor diagnoses you... WAIT IT OUT! I am currently 8.5 month pregnant. If I had listened to the doctor and chose an alternative route I would have given up my baby. I have had a totally healthy pregnancy because I chose to wait another week, at my final appointment when they were supposed to tell me my "options", the doctor still could not find the fetus, but at the very LAST second found a pulsation in the very back. This proved to later on be the heartbeat. Doctors can be careless, and can be wrong. So take my advice, and ride it out!
anonymous on December 02, 2009:
I was told I had a blighted ovum and that I should schedule a D & C. The transvaginal was done in the office by the doctor and he said that I could come back later in the week to check again but most likely that was what it was. Two days later I went back to have a "real" sonogram done by a tech with more high tech machine and long behold there was the yolk sac with the tiny baby and a little "blip" of a heartbeat. Thank god I got the real sonogram done. Beware that some of the older ultrasound machines don't pick up fine detail and if the person doing the ultrasound (even the doctor) doesn't know what they are doing you can have a misread. The details are so tiny early on you need proper machine to pick that up. Even when the tech did the ultrasound in one angle there was nothing and in another angle there was everything! Always make sure you have an official ultrasound done...............I'm so glad that I did!!